Crohns Disease

Topics: Crohn's disease, Ulcerative colitis, Gastroenterology Pages: 2 (445 words) Published: June 24, 2013
A Short Summary of Crohn’s Disease (Inflammatory Bowel Disease)

Epidemiology
Age of onset: 15-30 and 60-80
Equal incidence between males and females
Jewish>White Caucasian>African Americans>Hispanic>Asians •Ashkenazi Jews risk is 2x that of an Israeli born Jew. •Urban areas>Rural areas
High socioeconomic > low socioeconomic classes
Causes
1.Immune mediated
Pro-inflammatory>Anti-inflammatory
T-helper cells activation through cytokines to promote fibrinogenesis +collagen production + activation of coagulation cascade 2.Genetics
Gene mutation at CARD 15 and XBP1 abnormal protein unfolding •AGT16L1 mutation inability to attack invasive bacteria. 3.Environmental factors
Diet: Animal+fish+milk protein increase risk. Vegetable protein decreases risk. •Smoking+ NSAIDS increases the risk of flares
4.Microbes
Multiple intestinal pathogens trigger inflammatory response. Symptoms
The basics: Nausea, vomiting, diarrhea, abdominal pain, bleeding, appetite and weight loss, fever •Location: Any portion of GI tract from Mouth to Anus, involving the terminal ileum with skip lesions through out. •Morphology: Transmural lesions with cobble stone mucosa on barium swallow •Extra intestinal manifestations:

oJoint pain: Arthritis, Ankaylosing Spondylitis (CD>UC)
oFatty liver: Primary Sclerosing Chlongitis (UC>CD)
oUveitis: Blurred Vision and Photophobia
oSkin: Erythema nodosum, pyoderma gangrenous
Complications:
oSmall bowel obstruction: lack of bowel movements and inability to pass gas. oFistulae formation: depending on the organ involved may not require any therapy and may require surgery. Abscesses, or collections of pus, require drainage via surgery oMalabsorption of KADE vitamins: Osteoporosis, Increased PT, Kidney stones oColorectal Cancer: Only if CD involved the Colorectal region, otherwise cancer is rare only in long term active CD. •Distribution: Upper GI-5%, SM 30%, Ilocolic- 50%,...
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